41512 Tongue base suspension, permanent suture technique

Name of the Procedure:

Tongue Base Suspension, Permanent Suture Technique

Summary

Tongue base suspension using a permanent suture technique is a surgical procedure designed to open the airway by securing the base of the tongue to prevent it from collapsing during sleep.

Purpose

This procedure addresses obstructive sleep apnea (OSA), a condition where the airway becomes blocked during sleep, causing breathing interruptions. The goals are to improve breathing, reduce sleep disturbances, and enhance overall sleep quality.

Indications

• Moderate to severe obstructive sleep apnea
• Symptoms such as loud snoring, daytime fatigue, and choking or gasping during sleep
• Ineffectiveness of other treatments like CPAP (Continuous Positive Airway Pressure)

Preparation

• Patients may need to fast for several hours before the procedure.
• Medication adjustments might be required, particularly for blood thinners.
• Pre-procedure assessments typically include a sleep study, physical examination, and imaging studies (e.g., X-ray, CT scan).

Procedure Description

1. The patient is placed under general anesthesia.
2. A small incision is made in the tongue base or the neck.
3. Permanent sutures or slings are carefully positioned to lift and secure the base of the tongue.
4. The sutures are anchored to surrounding structures to maintain the tongue's new position.
5. The incision is closed, and the site is sterilized.

Tools: Surgical sutures, needles, scalpels, and possibly endoscopic equipment. Anesthesia: General anesthesia is used to ensure the patient is comfortable and pain-free.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

The procedure is performed in a hospital or a surgical center.

Personnel

• ENT (Ear, Nose, and Throat) surgeon or Otorhinolaryngologist
• Anesthesiologist
• Surgical nurses and technicians

Risks and Complications

Common: Postoperative pain, swelling, and temporary difficulty swallowing. Rare: Infection, bleeding, airway obstruction, and damage to surrounding tissues.

Benefits

Patients can expect a reduction in sleep apnea symptoms, leading to better sleep quality. Improvements are often noticed within a few weeks after surgery.

Recovery

• Patients may need to stay overnight in the hospital for monitoring.
• Post-procedure care includes pain management and antibiotics to prevent infection.
• Avoid strenuous activities and follow specific dietary instructions until healing progresses.
• Full recovery can take a few weeks, with follow-up appointments to monitor progress.

Alternatives

• CPAP therapy: Non-surgical option but may be uncomfortable for some.
• Oral appliances: Devices worn during sleep to keep the airway open.
• Other surgical options: Uvulopalatopharyngoplasty (UPPP), genioglossus advancement.

Pros and Cons: CPAP is non-invasive but requires consistent use. Oral appliances are less invasive but may not be effective for all patients. Other surgeries might have different risk profiles and recovery times.

Patient Experience

During the procedure, the patient will be under anesthesia and not feel anything. Post-procedure, they might experience discomfort, sore throat, or mild pain, which can be managed with prescribed medications. Most patients return to normal activities gradually, following their surgeon’s specific aftercare guidance.